国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Predictive Factors of Postoperative Seizure for Pediatric Patients with Unruptured Arteriovenous Malformations

第一作者:Yang, Haibo

通讯作者:Wang, Shuo

Arteriovenous malformation Pediatric Seizures Unru

基本信息

  • 负责人:Yang, Haibo
  • 数据来源: OTHERS
  • 论文编号:OTHERS20190572
  • 发表时间:2017-09-01

2017-09-01

已发表文章

发表杂志:World Neurosurgery

发表类型: Research Article

影响因子(IF): 2.104

PMID: 28522380 Pubmed原文链接 全文下载

主要研究背景及目的

方法

We performed a retrospective review of all surgically treated pediatric patients with unruptured AVM at our institution from 2001 to 2014. Patients younger than 18 years of age were included. Baseline variables was compared against our outcome of interest, which was defined as patients with or without follow-up seizures. Multivariable Cox regression was performed to identify potential predictive factors.

结论

Surgery may eliminate most seizures with low risk of inducing de novo seizures in pediatric patients with unruptured AVM. Predictive factors for postoperative seizures included large AVM size and temporal location. For selected unruptured AVMs with small size and nontemporal location, consideration of surgery as primary treatment for persistent seizures is a reasonable option.

主要结果

The average age of all patients was 13.1 years, and 68.2% were male. Nine patients were asymptomatic (13.6%), and seizure presentation occurred in 57.6% (n = 38). During an average follow-up of 4.2 years, 12 (18.2%) patients experienced postoperative seizures, with 5 (17.9%) of 28 patients with seizures being de novo. In patients with seizure presentation, 81.6% were completely seizure-free throughout follow-up. In multivariable analysis, larger AVM size (hazard ratio [HR] 1.63, P = 0.023) and temporal location (HR 8.35, P = 0.007) were found to increase the risk of follow-up seizures. On the contrary, seizure presentation (HR 1.91, P = 0.369) and postoperative infection (HR 2.37, P = 0.265) were not associated.